Hope Foundation of the Mahoning Valley
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H.O.P.E. Lifetime Achievement Award Nomination Form 2023
Nominee Information
Nominee Name
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First Name
Last Name
Nominee Organization/Employer (if applicable)
Nominee Email
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Verify Email
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Nominee Daytime Phone
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Nominee Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Nominator
Nominator Name
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First Name
Last Name
Nominator Email
*
Verify Email
*
Nominator Daytime Phone
*
Nominator Organization/Employer (if applicable)
Nominator Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Relationship to Nominee
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select one
Colleague
Family/Friend
Other
"Other"
Please answer the following questions, with examples, about your nominee.
**Nominees are strongly encouraged to assist in completing this form, as a winner will be chosen based on the information provided in the submission.
Why does your nominee deserve to receive this award? List and describe the significant examples.
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What has the nominee done to improve the quality of life for children and families in our community? List Specific Examples.
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How has your nominee inspired others through his or her actions? List Specific Examples.
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Has your nominee received any other awards or recognitions specifically for their work with quality of life for children and families? List and describe, if applicable.
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Any additional information pertaining to the nominee and the criteria. Discuss briefly the factors you feel are important for consideration.
Any additional documentation
Word or .pdf format
Submission Review
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I certify that I have read these Terms and Conditions, as stated here within this agreement, and attest that all the information provided in this application is true and correct. I further understand that any falsification or misrepresentation made in respect to this Agreement and its Application, or any accompanying documents, are subject to the forfeiture of funds, awards, including but not limited to any other forfeiture of goods and/or services presented by the Hope Foundation.
Typing your name below will act as your digital signature.
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